Clinicopathological Spectrum of Xanthogranulomatous Pyelonephritis

Area of Science:

• Nephrology
• Pathology
• Urology

Background:

• Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic kidney infection.
• It leads to significant renal destruction and functional impairment.
• Perinephric and peritoneal involvement are common in XGP.

Purpose of the Study:

• To elucidate the clinicopathologic spectrum of Xanthogranulomatous pyelonephritis.
• To analyze clinical, radiological, and histopathological features of XGP.
• To evaluate treatment outcomes for XGP.

Main Methods:

• Retrospective analysis of 40 histopathologically diagnosed XGP cases over 13 years.
• Review of clinical details and radiological findings.
• Detailed histopathological examination for definitive diagnosis.

Main Results:

• The study included 40 patients (26 female, 14 male; mean age 39.5 years).
• Flank pain was the most common symptom; all cases had unilateral disease requiring nephrectomy.
• Nephrolithiasis was present in 90% of cases; characteristic foamy macrophages were observed histologically.
• Coexisting renal carcinoma was noted in 5% of patients.

Conclusions:

• Histopathology is crucial for definitive XGP diagnosis based on characteristic morphology.
• Nephrectomy is the preferred surgical treatment, yielding favorable outcomes.
• XGP management requires a comprehensive understanding of its clinicopathologic features.